Symptoms, Signs, and Diagnosis
Posted by admin on November 25th, 2009The clinical features are comparable to those in younger persons and include a loud first heart sound, an apical diastolic rumble with presys¬tolic accentuation, and an opening snap. The latter may soften or disap¬pear with valvular calcification, and the diastolic murmur may become softer. A righl venlricular parasternal impulse is often palpable, and venous pressure may be elevated. Atrial fibrillation is more common in elderly patients, as is complicating arterial embolism.
Left atrial enlargemenl is oflen seen on chest x-ray. Electrocardio¬graphic evidence of right venlricular hyperlrophy is uncommon. Echo¬cardiography with Doppler flow studies can document mitral slenosis and help eslimale its severily. Left atrial myxoma may mimic mitral stenosis and can be differentiated by echocardiography.
